A cane is used to redistribute body weight on the forearm or wrist. It is recommended during the period of rehabilitation after minor injuries and to restore balance.
What to look for when buying a product
- The handle should be comfortable, reliable, not slippery, and the optimal size (not too big and not too small). Some canes are designed to be held with fingers or a brush, others are designed to support the forearm.
- The cane trunk can be solid, telescopic or folding, made of carbon fiber, metal or wood.
- Using the length adjustment step, the telescopic canes can be adjusted in height. The device operates by pressing a button mechanism.
- To ensure optimal stability, the tip of the product is most often made of rubber, sometimes with an anti-slip device (OPS). There are single-support, three-support and four-support canes. The more points of support, the more weight the cane can withstand.
An important parameter is the length of the cane.
- To choose the optimal length of the product, you need to stand upright, stretch your arms at the seams, shoes should not be removed. The top of the cane should touch the bend on the inside of the brush. A cane is suitable if the elbow is at an angle of 15–20 ° when standing.
- The length of the product, as a rule, is equal to ½ the height of a person in shoes.
- A cane should provide support in an upright position. If the cane is too short, you will have to bend, and if it is too long, you will have to bend towards the affected leg.
In which hand is it right to hold a cane
- If necessary, in an additional support, you need to hold a cane from the side of a healthy leg. For example, if the right leg needs support, you should hold a cane in your left hand and vice versa.
- For better balance, the working arm must be left free and the cane held with the other hand.
How to walk with a cane
- take a step with a sore foot
- move the cane forward
- distribute the weight on the cane and on the sore leg at the same time - thus, the product will take most of the body weight and unload the leg,
- when walking with a healthy foot, a cane should not be used.
How to walk up and down stairs with a cane
- grab the railing, if any, and put the cane in your free hand,
- step on the step with a healthy foot,
- raise or lower the sore leg there.
How to use a cane when walking on slippery surfaces
- Many canes are equipped with the device against sliding (UPS). The use of UPS provides stability and prevents falling when walking on wet slippery surfaces in the warmer months and during icy conditions.
How to use crutches
Crutches are the choice for those who need a serious level of support. The crutch will unload the sore leg as much as possible after operations on the knee or foot.
Crutch selection for height
- Axillary crutches must be selected so that their upper part is approximately 2.5 cm lower than the axillary cavity, and the handles are at the level of the hips.
How to walk on crutches
- move crutches to the ground at a distance of 30 cm from the body,
- lean forward
- step as if on a sore leg, at the same time transfer the weight to the crutches and move the legs forward between the crutches,
- the diseased leg should be kept in a raised position to avoid excessive pressure on it.
How to walk on crutches up or down steps
- put crutches together
- take crutches with one hand so that they are parallel to the floor,
- use the railing as a support and jump up or down the steps on a healthy foot.
How to sit and stand on crutches
- connect crutches
- take them with your hand from the side of a healthy leg as a long cane,
- Sit or stand slowly, leaning on crutches for balance.
How to use crutches when walking on slippery surfaces
- Some crutches are equipped with an anti-slip device (OPS). The use of UPS reduces the risk of falls and injuries when walking in the cold season on icy surfaces and in summer on moist slippery soil.
Do you know that:
- The rubber tips of canes and crutches should be changed from time to time.
- To maintain balance, it is best to look directly in front of you, not a support.
- To maintain the support means in working condition, it is necessary to periodically check the condition of the handles and tips.
Types of Crutches
- Axillary. Are required when it is necessary to completely remove the load from the legs. Usually this is the first recovery phase after an injury, which also implies a low load on the hands. It is not recommended to use more than two years.
- With elbow support. They are prescribed by the doctor when the patient can already walk or stand for a short time on his own, he has enough stamina to give some strain on his hands. Provide partial unloading of the limb, which at this stage of rehabilitation can already be stepped on. Suitable for continuous use, unlike axillary.
Which crutches are better and more comfortable, axillary or elbow?
Consider in detail each variety and selection rules.
Designed to transfer body weight from legs to arms and shoulder girdle. Fully unload the limbs, give the opportunity to walk without leaning on the leg. They are two slats that are connected down to one. Equipped with a stable non-slip tip. For convenient support, the upper part has a special pad that does not injure the armpit. The transverse crossbar, located at the level of the brush, is needed in order to hold on to it.
How to choose?
These orthopedic appliances are selected by height. Take into account the distance from the tip to the stop for the armpits, the level of the transverse crossbar.
- The patient needs to wear the usual shoes and stand up.
- The crutch must be placed at a distance of about 20 cm (depending on the width of the hips) from the foot.
If the patient cannot stand without support, then for him the devices are chosen as follows: height minus 40 cm. When using crutches, it will still need to be adjusted.
To assess the correctness of the selection on crutches, you need to be a bit like:
- pain in the shoulders indicates that the devices are higher than necessary,
- if the shoulders are relaxed but the arms get tired, the height is insufficient.
Reliance in such models falls on the elbow and hands. They are suitable for those who can hold the weight of the body with their hands and lean on a damaged leg. Such crutches expand the patient's capabilities: with them it is easier to climb stairs, step over curbs, etc. In addition, they are combined with orthopedic devices. According to statistics, men walk on such crutches easier than women.
How to choose the right one?
- The patient needs to stand up, grab the handle, first resting his forearm on the cuff. Put the crutch at a distance of about 15 cm from the toe of the foot.
- The handle for the brush should be at the level of the wrist when the hand is freely lowered.
- The cuff should be 5-10 cm from the elbow and tightly grasp the forearm without squeezing it. The elbow should be bent 15-20 °.
The distance to the cuff from the edge of the elbow, taking into account the growth of the patient:
- up to 150 cm - 4 cm,
- 170 cm - 5-7 cm,
- from 180 cm - 10 cm.
- Allow to keep balance.
- Provide ease of movement.
- They give you the opportunity to relax while walking, "hanging" on the armpits and relaxing your hands.
- Compact, easy to store, transport.
- Suitable for weakened and / or elderly people as an additional support, if possible, lean on both legs.
- Allow you to walk on the street, go down and climb the stairs.
- Make it difficult to climb and descend the stairs, walks.
- With incorrect adjustment, the neurovascular canal and lymph nodes in the armpit are squeezed, temporarily depriving the hands of sensitivity.
- If only one leg is possible (for example, after a fracture), they are suitable only for those with a strong shoulder girdle.
- Not suitable for weakened and / or elderly people, if possible, lean only on one leg.
- Inconvenient for patients with overweight.
- Do not apply after amputation of a limb.
Other important aspects:
- if it’s difficult for the patient to maintain balance, crutches with a pyramidal tip are recommended - they are more stable,
- axillary support should be anatomical or soft,
- the height of the crossbars must be adjustable,
- the standard weight of the device is about 1.5 kg, for overweight patients, reinforced models withstand up to 220 kg are suitable, however they weigh up to 4 kg, which leads to fatigue, therefore walkers are recommended for overweight people,
- wooden and alloy structures are designed for people with an average physique (weight up to 120 kg),
- if necessary, it is often better to go somewhere to choose a collapsible model.
How to learn to walk on crutches?
Crutches need to be carefully adjusted and after that, little by little, start walking. Try to transfer body weight to the hands, and not to the armpits (otherwise they can be damaged). If you use canadas, you should make sure that the handle is always directed forward, and the cuff is held firmly, but without squeezing the forearm.
If both legs are damaged
When walking, one crutch is first put forward, then the leg, which is closer to it. Then - the second and second limb. This method provides good stability, but low speed. You can learn to walk based on two points - this will increase speed: at the same time, the right crutch and the left leg are put forward, then the left and right legs.
If one leg is damaged
The back and head should be kept straight, not leaning forward. While walking, crutches should be rearranged simultaneously about 30 cm forward (but not closer than 10 cm from the legs) and slightly to the sides. Then the weight is transferred to the hands, the body moves forward.
You need to get on your heel, while crutches are behind. After that - lean on a healthy limb and put your crutches forward.
How to sit down?
Approach the seat as close as possible, turn your back on it. Put crutches to a sore leg, lean on them and on a healthy limb and sit down.
Take crutches in your hand, the second - hold the handrail. When lifting: place crutches on the step on which you stand, holding the railing with your hand. Then, distributing the body weight between the crutches and the supporting arm evenly, put the healthy limb one step higher, straighten it, move the crutches.
Put crutches a notch below, after them move the injured leg, then a healthy one.
Crutches must not be set too far forward, because you will have to bend over, which is fraught with a loss of balance. You can also not jump up the stairs - you can unsuccessfully fall. If there is a staircase with a railing, then both crutches should be taken in one hand, and the second should lean on the railing and come down with their help.
- For winter time, it is better to purchase nozzles with spikes or crutches with a built-in retractable spike.
What are medical crutches?
Crutches were used in ancient Egypt. In 1917, Emil Schlick patented the first commercial crutch, the design of which consisted of a cane with a support on the shoulder. Later, A.R. Lofstrand Jr. developed the first devices with a height-adjustable feature that allows you to adjust the required length.
Over time, the design has not changed much, so the classic look is still most often used in medical practice.
The crutch is selected in accordance with the needs of the person. This can serve as a partial support, as well as the absolute support of the whole body.
They are mainly used after surgery or for fracture of the extremities to reduce the load on the legs. There are also special crutches (they completely take on body weight), which is necessary for people who cannot normally move independently.
A typical crutch with a hardwood armrest has a depth of 20 inches — these are two connected long slats about 4 feet or more long, which taper downward and diverge upward, for example, with the letter “Y”, to a maximum width of about 5 inches at the top. Upstairs is a soft horizontal piece with a width of 6 to 8 inches, which is suitable for supporting the body under the armpit. In the middle of the device between the tapering shafts is a jumper used as a handle. Holes, bolts and wing nuts on the sides of the lower shaft, as well as two tapering upper shafts allow a person to adjust the length and position of the handle.
A conventional aluminum armrest has a similar design with buttons that make it easy to adjust. The handle is usually metal, has one shaft with a protruding handle and cuffs that covers the hand. Crutches have a special rubber tip at the bottom.
Types of Crutches
These supports are of several types:
- with leg support.
Axillary crutches place the handle perpendicular to the chest under the armpit. They are commonly used to support patients who have a temporary restriction on movement. Such canes sometimes require a towel or some soft coating to prevent or reduce damage to the armpit.
A complication known as crutch paralysis can occur due to pressure on the nerves in the armpit or armpit. In particular, the brachial plexus in the armpit is often damaged by the pressure of the handle. In these cases, the most common nerve in the forearm is radial, and the ulnar nerve suffers nearby to the same extent.
An unusual type of axillary cane is a spring-loaded crutch. The armpit lining is a curved structure that is open in front with hand grips that can provide maximum comfort and reduce the incidence of injuries associated with overuse.
This view also contains a spring mechanism underneath. The idea of its design is to allow the user to move further, which leads to a faster movement from place to place, although studies have shown that the difference in speed is very small when compared with standard axillary crutches. They are most often used by young people.
A typical forearm crutch has a cuff on top that covers it. It is used by inserting a hand into this device and holding the grip.
The cuff, usually made of plastic or metal, can be in the form of a semicircle or a full circle with a V-type hole in front, allowing the forearm to be pushed out in the event of a fall.Forearm canes are the dominant type in Europe for both short and long term use. Outside, they are likely to be used by patients with serious impairments, since axillaries are a more common option for short-term use.
Platform crutches are less common and are used by those with poor hand grip due to arthritis, cerebral palsy, or other conditions. The hand rests on a horizontal platform and is fixed in place, and if it is correctly designed, it can be tilted accordingly depending on the user's disability.
Leg support is a special type of crutch. This unconventional support is useful for users with injury or disability affecting only one leg. They function by tying the affected leg into a support frame, which simultaneously holds the lower part from the surface, transferring the load from the ground to the knee or thigh of the user. This style has the advantage that the patient does not use his hands while walking.
They have several advantages:
- free your hands
- reduce the load on the thigh
- the second leg is free
- the ability to partially use a sore leg.
Thus, atrophy of the upper thigh is reduced because the affected leg remains in operation. Unlike other designs, this device is not suitable for injuries of the pelvis or thigh, and in some cases for knee injuries. Because of this, walking canes can be used in addition to this device. However, they are held in the hand and have limited bearing capacity.
How to use crutches?
When using one crutch, you can notice that it is placed on the side of the unprotected leg. Those who can adapt to partial weight transfer on both legs usually use a four-point gait. Those who can tolerate a partial load on both legs, but need less support than a four-point gait, usually use a two-point gait. The sequence is the right crutch with the left foot, and then the left crutch with the right foot. The three-point type of walking is usually used by those who cannot gather all the weight on one leg. Both crutches promote body weight on a healthy leg. Then this leg moves under the weight on the canes.
A person with an injury usually performs a “turning” gait: raising the affected leg, the user places both crutches in front of him, and then shakes his intact leg to meet them.
A knee scooter and a wheelchair are alternatives for patients who cannot use or do not like the usual support. However, these wheeled devices impose an additional restriction, since they cannot operate on the stairs.
How to choose crutches?
Crutches are made in different sizes, suitable for people with their individual growth. Most of them are made of wood or tubular aluminum. The standard type is the high support, which extends under the armpit with double uprights and a small horizontal handle between them. The lower part can be adjusted to allow expansion. Always have a rubber suction tip to prevent slipping.
The Lofstrand crutch is often used, consisting of a single aluminum tube topped with a metal cuff that fits around the forearm. Thus, the user maintains his weight. He can release the handle and grab the railing to climb the stairs without dropping the fixture. The Lofstrand variant is a crutch of the Canadian elbow extensor, which goes further along the arm.
When walking with crutches, the forces of movement are transferred upside down. The muscles of the arms, shoulders, back, and chest work together to manipulate crutches. The type of crutches used largely depends on the nature of the disability. In some cases, the legs can partially function and carry part of the body weight, so that help from crutches is several times less. In other cases, leg braces are required for reinforcement.
The user independently learns one of several standard methods or trips, depending on the underlying condition. In the end, the patient must learn two main rules: a quick way to move for speed outdoors and a slow one for crowded places where the main need is to maintain balance. Different walks also help relieve fatigue, because one set of muscles can relax while the other is working actively.
When describing a walk, each leg and cane is called a point. In this case, a two-point gait, for example, means that two out of four points are in contact with the ground during one step. A three-point gait can be used when one leg is stronger than the other - two crutches and a weaker leg are simultaneously fixed on the ground, and the next step is done with a strong limb. Also in medicine, there is a so-called tripod (swinging) gait.
This material will be useful when choosing crutches and their direct use.
Crutches with elbow support
Elbow types are designed to support the wrist and forearm, when it is necessary to keep the weight not fully, but only partially. Such devices are preferred for those who have problems with the shoulder joint, when the axillary option causes pain. This model is called the "canadian" in honor of the invention of their Canadian resident, infected with polio.
There are also modifications to products with various devices. For example, a telescopic version with the ability to change length, Boruvka crutches - telescopic, folding and equipped with a safety pedal for shoes.
All crutches are made of light and durable materials - special types of wood, aluminum alloys, plastics. They have devices for support and against sliding.
The first option is the optimal one, in the presence of the patient, it gives the opportunity for a more adequate selection, the opportunity to try and adapt faster in the future. The selection algorithm is as follows:
- the patient becomes with a straightened body, shod, puts a crutch vertically next to him,
- the hand on the sore side is freely lowered and slightly bent at an angle of 25-30 °,
- set the distance of the top of the crutch to the lower edge of the armpit 5 cm, and its lower end 15 cm from the toe of the foot,
- the handle for the brush should be at the level of the wrist if the brush is straightened, or at the level of the fist.
In the absence of the patient, the axillary option is selected according to height, calculating their length according to a simple formula: growth minus 40 cm.
Crutches under the elbow
In order to choose this view with optimal support under the elbow, you need:
- stand up and straighten the torso,
- bend the arm on the sore side in the elbow at an angle of 20 °,
- put the crutch parallel to the leg,
- the distance from the elbow to the retaining cuff should be at least 5 and not more than 10 cm.
Which view is better to choose
The question of which crutches are suitable and will be more convenient - axillary or elbow is decided by the doctor in each case. The selection criterion in this case is the nature of the pathology of the limbs.
Axillaries are usually used in the process of immobilization in fractures, after operations, when it is completely impossible to load the leg. As they are restored, they are replaced with the elbow version.
Shoulder option is not recommended for more than 2 years. Practice shows that prolonged squeezing of the axillary region and shoulder leads to the development of brachial neuritis.
Therefore, for longer use, elbow models are better suited.
When choosing any type, it is important to consider the weight of their future user. If it does not exceed the norm, it is better to use models of light materials weighing up to 1.5-2 kg, for obese people, weighted models of metal weighing 4 kg and more will be more reliable.
In any case, when choosing a type of crutches, you must be guided by the recommendation of a doctor.
How to get up
To get out of the chair, you need to straighten the torso and head, so balance is better maintained. The end of the crutch should be at a distance of 25-30 cm from the foot, but not closer than 10 cm. The healthy knee and arms at the elbows are slightly bent, an indistinct test push is made - they try to tear the body off the floor, then put more emphasis on the hands. The upper ends of the crutches should be close to the body, and the lower ones should be 30 cm away from the leg, i.e. their axis has a slightly oblique direction.
Features of movement on the stairs
Particular care and rules must be observed in order to walk on crutches up the stairs. The general rule is to rest one hand on the railing and the other on both crutches. To climb up the stairs you need to slowly, in the following sequence:
- with one hand hold on to the railing slightly in front of the body, both crutches are taken in the other,
- “Balance” the body so that the support on the hands is approximately the same,
- put a healthy leg up a notch, pull the body up with the hands,
- then crutches are placed on the same step,
- each step is repeated again, with a sore leg laid back.
To go down the stairs, they do everything in the opposite order: they put crutches on the lower step, the sore leg is stretched out and retracted. Leaning on the railing with a hand, a healthy leg is placed on the lower step and the weight of the body is transferred, then everything is repeated. Movement on steps with the help of crutches is similar.
For a user who does not have sufficient experience, climbing stairs can be dangerous; it is better to use the help of an outsider.
Walking with one crutch is more convenient in the sense that one hand remains free. On the other hand, the load on one arm increases, especially if its muscle strength is insufficient and the body weight is large. A crutch is located near a healthy arm, first it is pushed forward and a straightened sore leg, then they rest on a healthy leg, transferring body weight to it and to the arm.
Alternative to crutches
There are other devices with which you can move with one supporting leg. These include canes - folding, with a double handle and a seat, with several supporting legs and cuffs for hands.
Another alternative device is walkers, which significantly reduce the support of the body on the muscles of the hands. There are many models - adjustable, folding, with wheels. What is better to prefer - crutches or walkers, depends mainly on age and general condition. For older and weakened people, an alternative is more suitable.
Recently, an electronic device such as a “smart orthosis” on the leg was invented in the United States, which will help the patient move freely on any surface and transmit signals about the condition of the damaged leg using a smartphone.
Where to get, cost
Crutches can be purchased at pharmacies, medical equipment and orthopedics stores, their price depends on the material, size, accessories, and varies from 300 to 6000 rubles. For temporary use, there is free rental, and for disabled people and veterans in the social services center, free issuance is organized.
In order for crutches to be a reliable and convenient means of transportation, you need to choose them on the recommendation of a doctor, adjust and adjust for yourself, to master the skills of proper use.